| NPI | 1164886362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TN 11866) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 7459) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 018001994) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 223) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS041277) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MS OS-6030-22) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2022-11-01 |